Pregnancy Essentials

Pregnancy Weight Gain: New Guidelines

How Much Weight Should Women Gain During Pregnancy? Maybe Less Than You Think

WebMD News Archive

Preconception Counseling

The IOM's new guidelines call for women to be offered preconception counseling that includes their weight, diet, and physical activity.

Most women don't get preconception counseling, Rasmussen says.

Goist agrees. Only about 10% of her patients ask how they can get healthier before pregnancy, and "probably less than 1% of those patients are women who are obese with concerns that maybe they need to lose weight prior to getting pregnant," Goist says.

"It would be huge" for all women considering pregnancy to get preconception counseling, Goist says. "I think that if all patients thought that's what they were supposed to do, potentially we would have more patients doing it."

Delaying Pregnancy to Lose Weight

The new IOM guidelines call for preconception counseling to include access to contraception for overweight or obese women who decide to use birth control as they work toward a healthy weight.

Rasmussen acknowledges debate among obstetricians about whether overweight or obese women should consider contraception until reaching a healthy weight.

"But certainly, we would like to see as many women as possible conceive at a healthy weight that will reduce their general obstetric risk," Rasmussen says.

Goist says most of her patients don't like the idea of delaying pregnancy so they can lose extra pounds.

"When you're telling a patient, 'I want you to take a break for six months and try to lose 20 pounds,' they think that you might be the devil incarnate," Goist says.

But Goist says most of her overweight patients already know that they need to lose some weight, and that it helps to talk with them about taking care of their own health so they can be there for their kids as they grow up.

"Your mentality changes when you're a mom, because you have other people to take care of," she says.

An avid exerciser and mother of two, Goist says she didn't have trouble gaining the right amount of weight during her pregnancies, in part because she wanted to be a role model to her patients. Even so, she says "it was harder to lose the weight the second time vs. the first time."